Against 6 peers โ similar data coverage. Comparing to a named peer set rather than a 51-state average.
Spending per member/month
$960
โ13.3% vs peer median
6th highest of 7 similar states
CMS-64 total รท CMS enrollment
Total Medicaid spending
$10,835,314,555
26th highest of 51 states
CMS-64 Total Net, FY2024
Medicaid enrollment
874,182
27th highest of 51 states
Most recent CMS monthly report
Visible in claims
41.1%
+8.6% vs peer median
2nd highest of 7 similar states
Share of program these claims see
Published figures are FY2024 CMS-64 and CMS enrollment. Claims figures cover 2018โ2024.
Public-record research has been run on 38 flagged Connecticut providers, including 10 seeded from the state's enforcement record. Fourteen referrals, the most of any state, nearly all convictions for billing Medicaid psychotherapy or counseling never rendered; Connecticut's June 2022 SUD residential benefit explains the largest structural step changes. Methodology
CMS T-MSIS data, 2018-2024
Concourse Sentinel connects to large-scale healthcare billing datasets โ including CMS T-MSIS claims, provider enrollment (PECOS), and federal exclusion lists โ and runs millions of automated statistical analyses to surface billing anomalies and areas warranting further review.
$28.0B
Cumulative, Jan 2018 โ Oct 2024 (6.8 years)
โ $4.1B / year
669.6M
Cumulative, Jan 2018 โ Oct 2024 (6.8 years)
โ 98.0M / year
7.9K
Distinct billing NPIs, Jan 2018 โ Oct 2024
417
49 highest/critical risk
Current (as of latest ETL)
| Code | Description | Total Paid | Claims |
|---|---|---|---|
| T1015 | Clinic service | $3.5B | 23.8M |
| 99285 | Emergency dept visit hi mdm | $1.5B | 4.6M |
| T1502 | Medication admin visit | $1.3B | 24.3M |
| 99284 | Emergency dept visit mod mdm | $1.2B | 6.5M |
| 99214 | Office o/p est mod 30 min | $1.1B | 19.3M |
| 90837 | Psytx w pt 60 minutes | $883.7M | 10.4M |
| 99213 | Office o/p est low 20 min | $834.5M | 25.5M |
| 99283 | Emergency dept visit low mdm | $775.6M | 5.6M |
| H0020 | Alcohol and/or drug services; methadone administration and/or service | $763.4M | 59.2M |
| G0463 | Hospital outpt clinic visit | $556.8M | 6.3M |